Psicodinâmica das relações incestuosas: assassinato e renascimento da alma em preciosa / Psychodynamics of incestuous relationships: murder and rebirth of soul in precious / Psicodinámica de las relaciones incestuosas: asesinato y el renacimiento del alma en preciosa

A linguagem dos filmes é vigorosa em facilitar processos formativos na clínica de orientação psicanalítica, pois metaforiza situações e contextos humanos, inclusive relações familiares incestuosas (RFIs). O trabalho teve como objetivo discutir um caso fílmico que focaliza RFsI encenadas por um casal parental e por uma filha. Preciosa: uma história de esperança, filme estadunidense dirigido e produzido por Lee Daniels em 2009, foi analisado qualitativamente por meio de teorias e discussões clínicas sobre a psicodinâmica familiar. A família de Preciosa é entendida de modo integrado, havendo mutualidade de influências entre seus diferentes membros, que se relacionam conforme os limites e potencialidades impostos pelo desenvolvimento psicossexual de cada um deles. Todos os envolvidos nas RFIs precisam enfrentar a tarefa de elaborar segredos familiares, os quais são transmitidos por via inconsciente de geração a geração. Preciosa ilustra a importância das funções familiares para a constituição das subjetividades e retrata desafios contemporâneos que se apresentam ao trabalho do clínico.

The language of movies is powerful to facilitate formative processes in clinical psychoanalysis, because it metaphorizes human situations and contexts, including incestuous family relationships (IFR). The study aimed to discuss a filmic case focused on IFR, staged by a parental couple and a daughter. Precious: based on the novel "Push" by Sapphire, American film directed and produced by Lee Daniels in 2009, was qualitatively analyzed through theories and clinical discussions about family psychodynamics. The family of Precious is understood an integrated manner, with mutual influences between its different members, according to they relate to the limits and potentialities of psychosexual development imposed by each. All involved in IFR must address the task of drawing up family secrets, unconscious and transgenerationally transmitted. Precious illustrates the significance of family functions for the formation of subjectivities and portrays contemporary challenges that confront the clinician's work.

El lenguaje de las películas es vigoroso para facilitar procesos formativos en la clínica de orientación psicoanalítica, porque metaforiza situaciones y contextos humanos, incluyendo relaciones familiares incestuosas (RFI). El trabajo tuvo como objetivo discutir un caso de película centrado en RFI, escenificado por una pareja parental y por una hija. Preciosa, película estadounidense dirigida y producida por Lee Daniels en 2009, fue analizada cualitativamente, por medio de teorías y discusiones clínicas sobre psicodinámica familiar. La familia de Preciosa es entendida de modo integrado, habiendo mutualidad de influencias entre sus diferentes miembros, que se relacionan conforme los límites y potencialidades impuestos por el desarrollo psicosexual de cada uno de ellos. Todos los involucrados en las RFI necesitan enfrentar la tarea de elaborar secretos familiares, los cuales son transmitidos por vía inconsciente y transgeneracional. Preciosa ilustra la importancia de las funciones familiares para la constitución de las subjetividades y retrata los retos contemporáneos que se presentan al trabajo del clínico.

Sexual harassment in the physician-patient interaction: analysis of charges against doctors in the state of São Paulo

OBJECTIVE: This research intends to discuss sexual harassment within the doctor-patient relationship based on four parameters: doctor's characteristics, accuser's characteristics, accusation characteristics, and the evaluation by the Medicine Council of São Paulo. METHOD: It is a descriptive, quantitative approach using a retrospective documental analysis. Studied subjects were doctors who were allegedly engaged in sexual harassment. This analysis considered all accusations made from January 2000 to December 2005 (n=150). RESULTS: For this type of sexual abuse, there was a prevalence of male professionals (96.6 percent) who committed abuse against female patients (90.3 percent) during adulthood (77.7 percent). The mean age of the accused was 46.87 years, ranging from 30-76 years, concentrated between 46-75 years. The intrinsic difficulty of understanding sexual harassment by a professional constrained ethical evaluation of the cases, with 24.1 percent of the cases being considered proceeding charges by the professional council. When the cases were recognized as proceeding, they were either filed (88.2 percent) or were considered to be ethical infringement (11.8 percent) becoming Professional Ethical Process (PEP). In the majority of proceeding cases (87 percent), there was a Police Occurrence Report enclosed. DISCUSSION AND CONCLUSION: The incidence of sexual abuse by professionals was independent of education, as the accused professionals came from a large variety of medical colleges, without significant differences related to institution. The predominance of accusations against older professionals may occur due to the frail personality structure that allows professional acting out. Objective evidence is very important in ethical evaluations compared to psychological and subjective evidence.

A função da confidencialidade: bioética e incesto / The function of confidentiality: bioethys and incesto

Este estudo pretende construir uma reflexão sobre a função da confidencialidade para os profissionais de saúde que lidam com pessoas envolvidas em casos de incesto, na tentativa de avaliar os limites éticos destas intervenções. A metodologia utilizada constituiu-se por uma reflexão teórica referendada pela Bioética e pela Psicanálise e ilustrada por uma pesquisa realizada com os profissionais de Saúde do Pronto-Atendimento Pediátrico do Hospital Universitário da Faculdade de Medicina da Universidade de São Paulo. A ausência do conflito entre a quebra do segredo profissional e a manutenção do vínculo de confiança entre profissional e paciente nestes casos demonstra a dificuldade de os profissionais lidarem com o incesto, o tabu estruturante da cultura, e de discriminarem a função de um profissional de Saúde...

This work intends to build up considerations about the confidentiality function for health professionals who deal with people involved in cases of incest, trying to evaluate the ethical limits of these interventions. The methodology used was a theoretical reflection based on Bioethics and Psychoanalyses and was illustrated by research with health professionals from Pediatric Emergency Room at University Hospital of São Paulo University. The absence of conflict between breaking professional secrecy and the maintenance of the reliance bond between the health professional and the patient shows the difficulties for the professionals to deal with the incest, the structuralizing taboo from the culture, and to discriminate the function of a health professional in those cases...